Eating Disorders Clinical Trial
— REDs-SwedenOfficial title:
The Relative Energy Deficiency in Sports (REDs) in Swedish Athletes Study
NCT number | NCT06371963 |
Other study ID # | LinnaeusU REDs |
Secondary ID | |
Status | Recruiting |
Phase | |
First received | |
Last updated | |
Start date | May 10, 2022 |
Est. completion date | December 2026 |
Background: Relative Energy Deficiency in Sport (REDs) describes impairment of health and performance due to problematic (long-term/severe) low energy availability (LEA), with or without eating disorders. LEA is frequently reported in sports with high training volumes, especially in leanness demanding sports, and 20% of female and 9% of male Norwegian national team athletes have been reported to have eating disorders. Potential trigger factors are e.g., dieting, injuries, coaching behavior, and subculture aspects e.g., focus on low body weight. The main questions that will be addressed are: 1. What is the prevalence of eating disorders and REDs among Swedish elite athletes and controls? 2. What is the impact of problematic LEA on health and performance aspects in both male and female athletes? Methods: National team athletes and gender and matched controls will be invited to an anonymous on-line survey. Elite athletes who agree to participate, will be invited to assessment of eating disorders, nutritional and physiological status (e.g., metabolic and endocrine markers, bone health, microbiota, dietary intake, energy availability, and performance).
Status | Recruiting |
Enrollment | 500 |
Est. completion date | December 2026 |
Est. primary completion date | May 2024 |
Accepts healthy volunteers | Accepts Healthy Volunteers |
Gender | All |
Age group | 18 Years to 45 Years |
Eligibility | Inclusion: - National-team level athletes - Non-elite athletic controls Exclusion (physical assessment): - chronic illness (e.g., diabetes, hypothyroidism) - injury - smoking - pregnancy - hormonal contraceptive use |
Country | Name | City | State |
---|---|---|---|
Sweden | Linnaeus University | Kalmar | Småland |
Lead Sponsor | Collaborator |
---|---|
Linnaeus University | Swedish Olympic Committee, Swedish Research Council for Sport Science, World Anti-Doping Agency |
Sweden,
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* Note: There are 19 references in all — Click here to view all references
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Self-reported eating disorders | Participants: Female and male elite athletes and age and gender matched controls.
An on-line version of the Eating Disorder Examination Questionnaire (EDE-Q) will be used comprising of 28 items, 4 sub-scales (restrained eating, eating-, body-, and weight concerns), and a global score. An EDE-Q global score = 2.3 for females and =1.7 for males indicate risk of eating disorder. |
Day one | |
Secondary | Eating disorders | Participants: Elite athlete and controls.
Diagnostic interview using the eating disorder examination (EDE-16). |
Through study completion, an average of 1 year | |
Secondary | Self-reported reproductive function in females not using hormonal contraceptives | Participants: Elite athletes and controls.
The Low Energy Availability in Females Questionnaire (LEAF-Q) comprises 25 items divided into 4 variables: 1) gastrointestinal symptoms, 2) injuries, 3) hormonal contracptives and 4) menstrual function that are scored on a Likert scale (0-46). The higher the score the higher risk of gastrointestinal dysfunction, injuries and menstrual dysfunction. Menstrual cycle lengths = 21 days and = 35 days resulting in 9 or more consecutive periods per year indicate eumenorrhea plus results from outcome 4. Primary amenorrhea: No menarche by age 15 years Oligomenorrhea: menstrual cycle length > 35 days plus results from outcome 4. Secondary amenorrhea: absence of = 3 consecutive menstrual bleedings. No menarche or no menstrual bleeding the last 3 months plus results from outcome 4. |
Day one | |
Secondary | Reproductive function in females not using hormonal contraceptives | Participants: Female elite athletes (n=28).
Eumenorrhea: evidence of luteinizing hormone surge, and estrogen, androgen and prolactin levels within normal reference range plus correct categorization by outcome 3. Oligomenorrhea and secondary amenorrhea: androgens and prolactin levels within normal reference range plus correct categorization from outcome 3. |
Through study completion, an average of 1 year | |
Secondary | Self-reported reproductive function in males | Participants: Elite athletes and controls.
Low Energy Availability in Males Questionnaire (LEAM-Q) comprising of 4 items regarding libido. A low sex drive score is generated by using scores equal or greater than 2 on "Sex drive in general" or equal or greater than 2 on "The number of morning erections" and equal or greater than 1 for "Morning erections compared to normal" to represent reproductive dysfunction plus results from outcome 6. |
Day one | |
Secondary | Reproductive function in males | Participants: Male athletes (n=16).
Total and free testosterone levels in the rested and fasted state. Clinically low levels or levels within the lowest quartile of reference range is indicative of hypogonadotropic hypogonadism plus results from outcome 5. |
Through study completion, an average of 1 year | |
Secondary | Gastrointestinal function | Participants: Elite athletes and controls.
The LEAF-Q variable regarding gastrointestinal function will be used (se Outcome 5). |
Day one | |
Secondary | Injury | Participants: Elite athletes and controls.
The LEAF-Q variable regarding injury will be used (see Outcome 5). |
Day one | |
Secondary | Self- reported symptoms of depression | Participants: Elite athletes and controls.
Symptoms of depression will be assessed using the Major Depression Index comprising of 10 items that are rated on a 6-point Likert scale from 0 (no time) to 5 (all the time). The total score ranges from 0 to 50 where a higher score reflects more symptoms of depression. Recommended cut-off points are 21 for mild depression, 26 for moderate depression, and 31 for severe depression. |
Day one | |
Secondary | Compulsive exercise | Participants: Elite athletes and controls.
Compulsive exercise will be assessed using the Exercise Addiction Inventory that covers six core symptoms of behavioral addictions. Each item is scored on a Likert-scale from 1 (strongly disagree) to 5 (strongly agree) and a total score of >23 indicates high risk of addiction. |
Day one | |
Secondary | The motivation for behavioral changes | Participants: Elite athletes and controls.
The motivation for behavioral cahnges will be assesed by the Motivation to Change Questionnaire comprising 54 items scored on Likert scales where a higher core indicates poorer ability for behavioral changes. |
Day one | |
Secondary | Psychological flexibility | Participants: Elite athletes and controls.
Psychological flexibility will assessed using the Swedish Acceptance and Action Questionnaire that comprises of 6 items that are scored on a Likert scales (0-6). The higher the score the poorer psychological flexibility. |
Day one | |
Secondary | Changes in immune markers from pre to post exercise | Participants: female athletes (n=28) and male athletes (n=16).
Inflammatory cytokines and immune components will be assessed in the fasted and rested state and post and exercise test. |
Through study completion, an average of 1 year | |
Secondary | Microbiota | Participants: female athletes (n=28) and male athletes (n=16).
Fecal sample, next-generation sequencing of microbial 16S rRNA genes analyzing bacterial diversity, and composition. |
Through study completion, an average of 1 year | |
Secondary | Dietary intake | Participants: female athletes (n=28) and male athletes (n=16).
A 4-day weighed dietary registration using an electronic kitchen scale and an on-line nutrient program. |
Through study completion, an average of 1 year | |
Secondary | Maximal aerobic capacity | Participants: female athletes (n=28) and male athletes (n=16).
Maximal aerobic capacity (VO2peak) will be assessed by a bicycle ergometer exercise test using a heart rate monitor, an air-tight mask covering the mouth and nose and the Vyntus CPX system. |
Through study completion, an average of 1 year | |
Secondary | Explosive lower body power | Participants: female athletes (n=28) and male athletes (n=16).
Explosive lower body power will be assessed by a counter movement jumping test. |
Through through study completion, an average of 1 year | |
Secondary | Whole body strength | Participants: female athletes (n=28) and male athletes (n=16).
Whole body-strength and force production will be assessed by an isometric mid-thigh pull test. |
Through study completion, an average of 1 year | |
Secondary | Muscular power | Participants: female athletes (n=28) and male athletes (n=16).
Wingate-test (cycles at maximal effort for 30 seconds) will be performed to assess muscular power and anaerobic capacity. |
Through study completion, an average of 1 year | |
Secondary | Resting Metabolic Rate | Participants: female athletes (n=28) and male athletes (n=16).
Resting metabolic rate (kcal/day) will be measured using indirect calometry by a ventilated open hood system (Vyntus CPX). |
Through study completion, an average of 1 year | |
Secondary | Body composition | Participants: female athletes (n=28) and male athletes (n=16).
Fat free mass, fat mass and whole-body, femur and lumbar spine bone mineral density, will be assessed by dual-energy x-ray absorptiometry. |
Through study completion, an average of 1 year | |
Secondary | Body weight | Participants: female athletes (n=28) and male athletes (n=16).
Body mass will be assessed using bioimpedance (Inbody 700) |
Through study completion, an average of 1 year | |
Secondary | Body height | Participants: female athletes (n=28) and male athletes (n=16).
Height will be assessed using a stadiometer. |
Through study completion, an average of 1 year | |
Secondary | Glucose levels | Participants: female athletes (n=28) and male athletes (n=16).
Continuous glucose monitoring using the device by Dexcom. |
Through study completion, an average of 1 year |
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